ArticleJournal of acquired immune deficiency syndromes (1999)2018
Time to First-Line ART Failure and Time to Second-Line ART Switch in the IeDEA Pediatric Cohort.
Article in Journal of acquired immune deficiency syndromes (1999), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Onset and predictors of first-line antiretroviral therapy treatment failure among children in Ethiopia: a systematic review and meta-analysis.BMC pediatrics · 2024Pooled it
- Article
- Antiretroviral treatment failure and associated factors among people living with HIV on therapy in Homa Bay, Kenya: A retrospective study.PLOS global public health · 2023Article
- Article
- Effects of National Adoption of Treat-All Guidelines on Pre-Antiretroviral Therapy (ART) CD4 Testing and Viral Load Monitoring After ART initiation: A Regression Discontinuity Analysis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Outcomes After Second-Line Antiretroviral Therapy in Children Living With HIV in Latin America.Journal of acquired immune deficiency syndromes (1999) · 2021Article
- Improving Methods to Classify Perinatal versus Nonperinatal HIV Acquisition in Young Adolescents 10-14 Years of Age.The Pediatric infectious disease journal · 2021Article
- Addressing Pediatric HIV Pretreatment Drug Resistance and Virologic Failure in Sub-Saharan Africa: A Cost-Effectiveness Analysis of Diagnostic-Based Strategies in Children ≥3 Years Old.Diagnostics (Basel, Switzerland) · 2021Article
- FIRST- LINE ANTIRETROVIRAL TREATMENT FAILURE IN EAST AFRICAN CHILDREN.East African medical journal · 2021Article
- International epidemiology databases to evaluate AIDS (IeDEA) in sub-Saharan Africa, 2012-2019.BMJ open · 2020Article
- Outcomes of second-line antiretroviral therapy among children living with HIV: a global cohort analysis.Journal of the International AIDS Society · 2020Article
- Research priorities to inform "Treat All" policy implementation for people living with HIV in sub-Saharan Africa: a consensus statement from the International epidemiology Databases to Evaluate AIDS (IeDEA).Journal of the International AIDS Society · 2019Article
- Traversing the cascade: urgent research priorities for implementing the 'treat all' strategy for children and adolescents living with HIV in sub-Saharan Africa.Journal of virus eradication · 2018Article
- Using Observational Data to Inform HIV Policy Change for Children and Youth.Journal of acquired immune deficiency syndromes (1999) · 2018Observational
Corrections and comments
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Authors and funding
17 authors.
Funding
Abstract
backgroundGlobally, 49% of the estimated 1.8 million children living with HIV are accessing antiretroviral therapy (ART). There are limited data concerning long-term durability of first-line ART regimens and time to transition to second-line.
methodsChildren initiating their first ART regimen between 2 and 14 years of age and enrolled in one of 208 sites in 30 Asia-Pacific and African countries participating in the Pediatric International Epidemiology Databases to Evaluate AIDS consortium were included in this analysis. Outcomes of interest were: first-line ART failure (clinical, immunologic, or virologic), change to second-line, and attrition (death or loss to program ). Cumulative incidence was computed for first-line failure and second-line initiation, with attrition as a competing event.
resultsIn 27,031 children, median age at ART initiation was 6.7 years. Median baseline CD4% for children ≤5 years of age was 13.2% and CD4 count for those >5 years was 258 cells per microliter. Almost all (94.4%) initiated a nonnucleoside reverse transcriptase inhibitor; 5.3% a protease inhibitor, and 0.3% a triple nucleoside reverse transcriptase inhibitor-based regimen. At 1 year, 7.7% had failed and 14.4% had experienced attrition; by 5 years, the cumulative incidence was 25.9% and 29.4%, respectively. At 1 year after ART failure, 13.7% had transitioned to second-line and 11.2% had experienced attrition; by 5 years, the cumulative incidence was 31.6% and 25.9%, respectively.
conclusionsHigh rates of first-line failure and attrition were identified in children within 5 years after ART initiation. Of children meeting failure criteria, only one-third were transitioned to second-line ART within 5 years.
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